WO2003103503A1 - Endoscopic biopsy forceps with protected cutting instrument - Google Patents

Endoscopic biopsy forceps with protected cutting instrument Download PDF

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Publication number
WO2003103503A1
WO2003103503A1 PCT/FR2003/001746 FR0301746W WO03103503A1 WO 2003103503 A1 WO2003103503 A1 WO 2003103503A1 FR 0301746 W FR0301746 W FR 0301746W WO 03103503 A1 WO03103503 A1 WO 03103503A1
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WO
WIPO (PCT)
Prior art keywords
sheath
sleeve
operating
cable
integral
Prior art date
Application number
PCT/FR2003/001746
Other languages
French (fr)
Inventor
Jean-Paul Durand
Original Assignee
Odon Life Technology
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Odon Life Technology filed Critical Odon Life Technology
Priority to AU2003255661A priority Critical patent/AU2003255661A1/en
Publication of WO2003103503A1 publication Critical patent/WO2003103503A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws

Definitions

  • the invention relates to an endoscopic biopsy forceps, of the type of that of FR A 2 795 942, for single use and with means for actuating cutting means, such as it is by a conventional action on the fingers of its hand, that is to say by bringing them together, that the practitioner performs the biopsy.
  • an endoscopic biopsy forceps is a forceps which is introduced into a working channel of an endoscope, in which it is advanced until it appears in the field of vision, near a area from which tissue must be cut and removed.
  • the biopsy forceps of the invention comprises cutting means mounted on a distal end of a cable which extends in an internal sheath movably mounted in an external sheath and maneuvering means from which the proximal ends of the external sheath and cable are integral, the proximal end of the internal sheath being integral with a pull tab slidingly mounted on the operating means for actuating the cutting means.
  • the invention therefore relates to a biopsy forceps of the type defined above, characterized in that the maneuvering means comprise two parts, a maneuvering handle, of which the cable is integral and on which the zipper, and an operating sleeve, of which the outer sheath is integral, the handle and the zipper being arranged to be moved towards the sleeve to take the cutting means out of the distal end of the outer sheath.
  • the cutting means can, for example, eject a plug of medical paraffin.
  • the handle and the maneuvering sleeve are arranged to abut one against the other and thus reconstitute a unitary maneuvering member and thus secure the outer sheath and the moving cable.
  • the sleeve is slidably mounted on a tube integral with the handle.
  • the maneuvering sleeve comprises locking means in position on the internal sheath which the operator therefore maintains in the locked state during the phase of insertion and movement of the clamp in the working channel, before unlock them to slide the inner sheath and the cable in the outer sheath, up to the cutting position.
  • braking means could be proposed.
  • the maneuvering sleeve can be detachably and adjustable from the outer sheath, whereby the relative stroke of the handle and of the sleeve can be adapted to different lengths of sheaths. It will be noted that if the cutting means are no longer protected during the extraction phase of the biopsy forceps from the operating channel of the endoscope, this has absolutely no importance.
  • FIG. 1 shows the biopsy forceps of the invention in longitudinal section, the cutting means being in the protective position
  • FIG. 2 is a cross-sectional view of the clamp latch of the clamp of Figure 1;
  • FIG. 3 is a cross-sectional view of an alternative embodiment of the clamping means of the clamp of the invention.
  • Figure 4 shows the forceps of Figure 1, the cutting means being taken out of the distal end, in the biopsy position;
  • FIG. 5 is a cross-section view of the locking means of the clamp of FIG. 4 and
  • Figure 6 shows the forceps of Figure 4, the cutting means being removed just after expulsion of the protective cap, or just after biopsy.
  • the biopsy forceps comprises, at a distal end, a cutting and sampling instrument 1, and at the other end, called proximal, means 2 for maneuvering the instrument 1, comprising a operating handle 20, provided with rings 11, 12 and in which a zipper 22 slides provided with a ring 27, and an operating sleeve 35 in which the locking means 40 slide.
  • the sleeve 35 is a tabular sleeve fitted at the front, over part of its length, to the proximal end 36 of the sheath 10 to which it is secured.
  • the sleeve 35 is open at the rear so that it can slide on a rigid tube 39 secured to the operating handle 20.
  • the internal sheath 8 can be released over a portion of its width, at the level of a locking latch 40.
  • a cable 5 extends and slides, integral with the handle 20 from this handle to the cutting instrument 1.
  • the cutting and sampling instrument 1 conforms to that described in
  • FR A 2 795 942 and comprises two cutting spoons 3, 4 which are maneuverable like jaws which are opened or closed using the action of the sheath 8 on their external surface.
  • the locking means 40 are, here, constituted by a latch slidably mounted transversely on the sleeve 35, pierced by two communicating openings 43, 44 (FIGS. 2 and 5), one, 43, of narrowed opening, making it possible to block the sheath 8 ( Figure 2), the other, to let the tube 39 ( Figures 5 and 6), and possibly to brake it in its longitudinal movement.
  • the latch 40 can be manipulated by two pushers which are integral with it, the pushbutton 42 to bring the center of the narrowed light 43 in the axis of the sheath 8, and the pushbutton 41, to bring the center of the widened light 44 into the axis of the tube 39, which coincides with the axis of the sheath 10 which it extends and therefore that of the sheath 8, which can slide in the sheath 10.
  • the operating handle 20 and the operating sleeve 35 of the biopsy forceps are in the preparatory phase for introduction into an operating channel, positioned spaced apart from each other so that the tube 39 and the sheath 10 reveals the sheath 8 released in the enlarged lumen 44 of the latch 40.
  • the instrument 1 is positioned inside the distal end of the sheath 10.
  • This distal end is closed with a plug 50 of medical paraffin and, to avoid accidentally expelling this plug in the operating channel, the instrument is kept in this position by blocking the sheath 8 in the narrowed lumen 43 of the latch 40 by action on pusher 42.
  • the clamp is advanced in the working channel until the distal end of the sheath 10 reaches the position which it should approximately occupy when the sample is taken.
  • the sheath 8 is then released by acting on the pusher 41.
  • the tabe 39 is slid in the sleeve 35 to put the latter in abutment against the operating handle 20, the enlarged lumen 44 holding the sleeve and the handle in abutment by braking exerted by its walls on the tube 39.
  • This abutment operation causes the plug 50 to be expelled by the instrument 1 from the sheath 10 and the instrument 1 is then in a configuration ready for opening of the clamp, configuration illustrated in FIG. 6.
  • the biopsy forceps are then advanced until the cutting spoons 3, 4, in the open position of the forceps, come into contact with the area from which tissue must be cut and removed.
  • the clamp is opened by moving the pull tab 22 away from the handle 20.
  • the distal end of the internal sheath 8 is then in the retracted position on the cable 5 as illustrated in FIG. 2.
  • the practitioner pushes F distal end of the inner sheath 8 towards the spoons so that it comes to bring the spoons 3, 4 together to carry out the cutting thanks to their sharp edges, the distal end of the sheath 8 then being in abutment against the spoons, as illustrated again in FIG. 6.
  • the locking means 40 are doubled with a locking device 60, with reference to FIG. 3, similar and adjacent to the means 40, on the sleeve 35 ′, but blocking the sheath 10, this sheath being made to slide in the sleeve.
  • the sheath 10 is integral with the sleeve but detachably.
  • the sleeve 35 ′ is then really open at its two axial ends for the sliding of the tab 39 and of the external sheath 10. By unlocking this sheath 10, it is thus possible to adjust the stroke length of the tab 39 in the sleeve 35 as a function of the required stroke length of the instrument 1 from its protective position in the sheath 10 to its removal position.
  • the assembly can occupy two states, a first deployed state and a second folded state.
  • the deployed state the sheath 10 covers the cutting spoons 3, 4, the medical paraffin plug closing off its end to finish protecting the cutting spoons.
  • the folded back state the cutting function can be ensured. It is the transition from the deployed state to the folded state which causes the protective cap to be expelled by the cutting spoons.
  • the cutting instrument was thus protected from any contamination during its passage through an endoscope operating channel. During the biopsy, the patient is not exposed to any risk of infection.

Abstract

The invention concerns endoscopic biopsy forceps comprising cutting means (3, 4) mounted on a distal end of a cable (5) which extends into an inner sheath (8) mounted mobile in an outer sheath (10) and maneuvering means (2) whereto the proximal ends of the outer sheath (10) and of the cable (5) are secured, the proximal end of the inner sheath (8) being integral with a pull knob (22) slidably mounted on the maneuvering means (2) to actuate the cutting means (3, 4). The invention is characterized in that the maneuvering means (2) comprise two parts, a maneuvering handle (20), whereto the cable (5) is secured and whereon is mounted the pull knob (22), and a maneuvering sleeve (35), whereto the outer sheath (10) is secured, the handle (20) and the pull knob (22) being designed to be displaced towards the sleeve (35), to pull the cutting means outside the distal end of the outer sheath (10).

Description

Pince à biopsie endoscopique à instrument de coupe protègeEndoscopic biopsy forceps with protected cutting instrument
L'invention concerne une pince à biopsie endoscopique, du type de celle de FR A 2 795 942, à usage unique et avec des moyens d'actionnement de moyens de coupe, tels que c'est par une action classique sur les doigts de sa main, c'est-à-dire par rapprochement de ceux-ci, que le praticien procède à la biopsie.The invention relates to an endoscopic biopsy forceps, of the type of that of FR A 2 795 942, for single use and with means for actuating cutting means, such as it is by a conventional action on the fingers of its hand, that is to say by bringing them together, that the practitioner performs the biopsy.
On rappellera qu'une pince à biopsie endoscopique est une pince qu'on introduit dans un canal opérateur d'un endoscope, dans lequel on la fait avancer jusqu'à ce qu'elle apparaisse dans le champ de vision, à proximité d'une zone dont il faut couper et prélever des tissus.It will be recalled that an endoscopic biopsy forceps is a forceps which is introduced into a working channel of an endoscope, in which it is advanced until it appears in the field of vision, near a area from which tissue must be cut and removed.
Plus précisément, la pince à biopsie de l'invention comporte des moyens de coupe montés sur une extrémité distale d'un câble qui s'étend dans une gaine interne montée mobile dans une gaine externe et des moyens de manœuvre desquels les extrémités proximales de la gaine externe et du câble sont solidaires, l' extrémité proximale de la gaine interne étant solidaire d'une tirette montée coulissante sur les moyens de manœuvre pour actionner les moyens de coupe.More specifically, the biopsy forceps of the invention comprises cutting means mounted on a distal end of a cable which extends in an internal sheath movably mounted in an external sheath and maneuvering means from which the proximal ends of the external sheath and cable are integral, the proximal end of the internal sheath being integral with a pull tab slidingly mounted on the operating means for actuating the cutting means.
A chaque fois qu'on introduit une pince dans le canal opérateur, il y a frottement contre la paroi du canal, ce qui contribue à créer un film bactérien qui, sans autre précaution, provoquerait, par intermédiaire des moyens de coupe, la contamination des organes ciblés à biopser et donc des patients.Each time a clamp is introduced into the working channel, there is friction against the wall of the channel, which contributes to creating a bacterial film which, without other precautions, would cause, through cutting means, the contamination of target organs to be biopsied and therefore patients.
La demanderesse a donc songé à protéger les moyens de coupe de la pince à biopsie jusqu'à ce qu'ils atteignent l'organe à biopser, à proximité duquel elle propose de les découvrir pour qu'une contamination possible du canal opérateur ne puisse pas présenter d'inconvénient. A cet effet, l'invention concerne donc une pince à biopsie du type défini ci- dessus, caractérisée par le fait que les moyens de manœuvre comportent deux parties, une poignée de manœuvre, de laquelle le câble est solidaire et sur laquelle est montée la tirette, et un manchon de manœuvre, duquel la gaine externe est solidaire, la poignée et la tirette étant agencées pour être déplacées vers le manchon pour sortir les moyens de coupe hors de l'extrémité distale de la gaine externe.The Applicant has therefore thought of protecting the means for cutting the biopsy forceps until they reach the organ to be biopsied, close to which it proposes to discover them so that possible contamination of the working channel cannot present disadvantage. To this end, the invention therefore relates to a biopsy forceps of the type defined above, characterized in that the maneuvering means comprise two parts, a maneuvering handle, of which the cable is integral and on which the zipper, and an operating sleeve, of which the outer sheath is integral, the handle and the zipper being arranged to be moved towards the sleeve to take the cutting means out of the distal end of the outer sheath.
En sortant hors de la gaine externe, les moyens de coupe peuvent, par exemple, éjecter un bouchon de paraffine médicale.Leaving out of the outer sheath, the cutting means can, for example, eject a plug of medical paraffin.
De préférence, la poignée et le manchon de manœuvre sont agencés pour venir en butée l'un contre l'autre et reconstituer ainsi un organe de manœuvre unitaire et solidariser ainsi la gaine externe et le câble en déplacement.Preferably, the handle and the maneuvering sleeve are arranged to abut one against the other and thus reconstitute a unitary maneuvering member and thus secure the outer sheath and the moving cable.
Avantageusement, le manchon est monté coulissant sur un tube solidaire de la poignée.Advantageously, the sleeve is slidably mounted on a tube integral with the handle.
De préférence, encore, le manchon de manœuvre comporte des moyens de blocage en position sur la gaine interne que l'opérateur maintient donc à l'état de blocage pendant la phase d'introduction et de déplacement de la pince dans le canal opérateur, avant de les débloquer pour faire coulisser la gaine interne et le câble dans la gaine externe, jusqu'en position de coupe.Preferably, again, the maneuvering sleeve comprises locking means in position on the internal sheath which the operator therefore maintains in the locked state during the phase of insertion and movement of the clamp in the working channel, before unlock them to slide the inner sheath and the cable in the outer sheath, up to the cutting position.
A la place des moyens de blocage, on pourrait proposer des moyens de freinage.Instead of blocking means, braking means could be proposed.
Le manchon de manœuvre peut être solidaire de la gaine externe de façon détachable et réglable, grâce à quoi, la course relative de la poignée et du manchon peut être adaptée à différentes longueurs de gaines. On remarquera que si les moyens de coupe ne sont plus protégés lors de la phase d'extraction de la pince à biopsie hors du canal opérateur de l'endoscope, cela na absolument aucune importance.The maneuvering sleeve can be detachably and adjustable from the outer sheath, whereby the relative stroke of the handle and of the sleeve can be adapted to different lengths of sheaths. It will be noted that if the cutting means are no longer protected during the extraction phase of the biopsy forceps from the operating channel of the endoscope, this has absolutely no importance.
L'invention sera mieux comprise à l'aide de la description suivante d'une forme de réalisation préférée et du dessin annexé sur lequelThe invention will be better understood with the aid of the following description of a preferred embodiment and of the appended drawing in which
- la figure 1 représente la pince à biopsie de l'invention en coupe longitudinale, les moyens de coupe étant en position de protection ;- Figure 1 shows the biopsy forceps of the invention in longitudinal section, the cutting means being in the protective position;
- la figure 2 est une vue en coupe transversale du loquet de blocage de la pince de la figure 1 ;- Figure 2 is a cross-sectional view of the clamp latch of the clamp of Figure 1;
- la figure 3 est une vue en coupe transversale d'une variante de réalisation des moyens de blocage de la pince de l'invention ;- Figure 3 is a cross-sectional view of an alternative embodiment of the clamping means of the clamp of the invention;
- la figure 4 représente la pince de la figure 1, les moyens de coupe étant sortis hors de l'extrémité distale, en position de biopsie ;- Figure 4 shows the forceps of Figure 1, the cutting means being taken out of the distal end, in the biopsy position;
- la figure 5 est une vue en coupe transversale des moyens de blocage de la pince de la figure 4 etFIG. 5 is a cross-section view of the locking means of the clamp of FIG. 4 and
- la figure 6 représente la pince de la figure 4, les moyens de coupe étant sortis juste après expulsion du bouchon protecteur, ou juste après biopsie.- Figure 6 shows the forceps of Figure 4, the cutting means being removed just after expulsion of the protective cap, or just after biopsy.
En référence à la figure 1, la pince à biopsie comporte, à une extrémité distale, un instrument de coupe et de prélèvement 1, et à l'autre extrémité, dite proximale, des moyens 2 de manœuvre de l'instrument 1, comprenant une poignée de manœuvre 20, munie d'anneaux 11, 12 et dans laquelle coulisse une tirette 22 munie d'un anneau 27, et un manchon de manœuvre 35 dans lequel coulissent des moyens de blocage 40.Referring to Figure 1, the biopsy forceps comprises, at a distal end, a cutting and sampling instrument 1, and at the other end, called proximal, means 2 for maneuvering the instrument 1, comprising a operating handle 20, provided with rings 11, 12 and in which a zipper 22 slides provided with a ring 27, and an operating sleeve 35 in which the locking means 40 slide.
Le manchon 35 est un manchon tabulaire emmanché à l'avant, sur une partie de sa longueur, sur l' extrémité proximale 36 de la gaine 10 à laquelle il est solidarisé.The sleeve 35 is a tabular sleeve fitted at the front, over part of its length, to the proximal end 36 of the sheath 10 to which it is secured.
Le manchon 35 est ouvert à l' arrière pour pouvoir coulisser sur un tube 39 rigide solidaire de la poignée de manœuvre 20.The sleeve 35 is open at the rear so that it can slide on a rigid tube 39 secured to the operating handle 20.
Une gaine interne 8, solidaire de la tirette 22, s'étend et coulisse dans le tube 39, le manchon 35 et une gaine externe 10 solidaire du manchon 35 jusqu'à l'instrument de coupe et de prélèvement 1. Dans le manchon 35, entre le tube 39 et la gaine externe 10, la gaine interne 8 peut être dégagée sur une portion de sa largeur, au niveau d'un loquet de blocage 40.An internal sheath 8, integral with the pull tab 22, extends and slides in the tube 39, the sleeve 35 and an external sheath 10 integral with the sleeve 35 up to the cutting and sampling instrument 1. In the sleeve 35 , between the tube 39 and the external sheath 10, the internal sheath 8 can be released over a portion of its width, at the level of a locking latch 40.
Dans cette gaine interne 8, s'étend et coulisse un câble 5, solidaire de la poignée 20 depuis cette poignée jusqu'à l'instrument de coupe 1.In this internal sheath 8, a cable 5 extends and slides, integral with the handle 20 from this handle to the cutting instrument 1.
L'instrument de coupe et de prélèvement 1 est conforme à celui qui est décrit dansThe cutting and sampling instrument 1 conforms to that described in
FR A 2 795 942 et comporte deux cuillers de coupe 3, 4 se manoeuvrant comme des mâchoires que l'on ouvre ou que l'on ferme à l'aide de l'action de la gaine 8 sur leur surface externe. Pour plus de précisions sur l'mslrument, on pourra utilement se reporter à ce document de l'art antérieur ici donc introduit par référence.FR A 2 795 942 and comprises two cutting spoons 3, 4 which are maneuverable like jaws which are opened or closed using the action of the sheath 8 on their external surface. For more details on the mslrument, one can usefully refer to this document of the prior art here therefore introduced by reference.
Les moyens de blocage 40 sont, ici, constitués d'un loquet monté coulissant transversalement sur le manchon 35, percé de deux lumières 43, 44 communicantes (figure 2 et 5), l'une, 43, d'ouverture rétrécie, permettant de bloquer la gaine 8 (figure 2), l'autre, de laisser passer le tube 39 (figures 5 et 6), et éventuellement, de le freiner dans son mouvement longitudinal. Le loquet 40 est manipulable par deux poussoirs qui lui sont solidaires, le poussoir 42 pour amener le centre de la lumière rétrécie 43 dans l'axe de la gaine 8, et le poussoir 41, pour amener le centre de la lumière élargie 44 dans l'axe du tube 39, qui coïncide avec l'axe de la gaine 10 qu'il prolonge et donc celui de la gaine 8, qui peut coulisser dans la gaine 10.The locking means 40 are, here, constituted by a latch slidably mounted transversely on the sleeve 35, pierced by two communicating openings 43, 44 (FIGS. 2 and 5), one, 43, of narrowed opening, making it possible to block the sheath 8 (Figure 2), the other, to let the tube 39 (Figures 5 and 6), and possibly to brake it in its longitudinal movement. The latch 40 can be manipulated by two pushers which are integral with it, the pushbutton 42 to bring the center of the narrowed light 43 in the axis of the sheath 8, and the pushbutton 41, to bring the center of the widened light 44 into the axis of the tube 39, which coincides with the axis of the sheath 10 which it extends and therefore that of the sheath 8, which can slide in the sheath 10.
Ainsi, quand la gaine 8 est bloquée par le loquet 40 (figure 1, 2), le manchon 35 est maintenu éloigné de la poignée de manoeuvre 20, de sorte que l'instrument 1 est maintenu protégé par la gaine 10 et un bouchon de paraffine médicale 50.Thus, when the sheath 8 is blocked by the latch 40 (FIG. 1, 2), the sleeve 35 is kept away from the operating handle 20, so that the instrument 1 is kept protected by the sheath 10 and a stopper. medical paraffin 50.
De même, quand la gaine 8 est libérée, le manchon 35 et la poignée 20 peuvent être rapprochés et venir en butée l'un contre l'autre pour former (figure 4, 6) un organe de manœuvre unitaire 2.Similarly, when the sheath 8 is released, the sleeve 35 and the handle 20 can be brought together and come into abutment against one another to form (FIG. 4, 6) a unitary operating member 2.
Le fonctionnement de la pince à biopsie endoscopique va maintenant être décrit.The operation of the endoscopic biopsy forceps will now be described.
En référence à la figure 1, la poignée de manœuvre 20 et le manchon de manœuvre 35 de la pince à biopsie sont en phase préparatoire d'introduction dans un canal opératoire, positionnés éloignés l'un de l'autre pour que le tube 39 et la gaine 10 laissent apparaître la gaine 8 dégagée dans la lumière élargie 44 du loquet 40. Ce faisant, l'instrument 1 est positionné à l'intérieur de rextrémité distale de la gaine 10.With reference to FIG. 1, the operating handle 20 and the operating sleeve 35 of the biopsy forceps are in the preparatory phase for introduction into an operating channel, positioned spaced apart from each other so that the tube 39 and the sheath 10 reveals the sheath 8 released in the enlarged lumen 44 of the latch 40. In so doing, the instrument 1 is positioned inside the distal end of the sheath 10.
On obture cette extrémité distale d'un bouchon 50 de paraffine médicale et, pour éviter d'expulser accidentellement ce bouchon dans le canal opératoire, on maintient l'instrument dans cette position en bloquant la gaine 8 dans la lumière rétrécie 43 du loquet 40 par action sur le poussoir 42.This distal end is closed with a plug 50 of medical paraffin and, to avoid accidentally expelling this plug in the operating channel, the instrument is kept in this position by blocking the sheath 8 in the narrowed lumen 43 of the latch 40 by action on pusher 42.
On fait avancer la pince dans le canal opérateur jusqu'à ce que l'extrémité distale de la gaine 10 parvienne dans la position qu'elle doit approximativement occuper lorsqu'on effectuera le prélèvement. On débloque alors la gaine 8 en agissant sur le poussoir 41. On fait coulisser le tabe 39 dans le manchon 35 pour mettre ce dernier en butée contre la poignée de manœuvre 20, la lumière élargie 44 maintenant le manchon et la poignée en butée par freinage exercée par ses parois sur le tube 39.The clamp is advanced in the working channel until the distal end of the sheath 10 reaches the position which it should approximately occupy when the sample is taken. The sheath 8 is then released by acting on the pusher 41. The tabe 39 is slid in the sleeve 35 to put the latter in abutment against the operating handle 20, the enlarged lumen 44 holding the sleeve and the handle in abutment by braking exerted by its walls on the tube 39.
Cette opération de mise en butée provoque l'expulsion du bouchon 50 par l'instrument 1 hors de la gaine 10 et l'instrument 1 se trouve alors dans une configuration prête à l'ouverture de la pince, configuration illustrée sur la figure 6.This abutment operation causes the plug 50 to be expelled by the instrument 1 from the sheath 10 and the instrument 1 is then in a configuration ready for opening of the clamp, configuration illustrated in FIG. 6.
On avance alors la pince à biopsie jusqu'à ce que les cuillers de coupe 3, 4, en position d'ouverture de la pince, viennent en contact avec la zone dont il faut couper et prélever des tissus. La pince est ouverte en écartant la tirette 22 de la poignée 20. L'extrémité distale de la gaine interne 8 est alors en position reculée sur le câble 5 comme illustrée sur la figure 2. Par rapprochement de ses trois doigts glissés dans les anneaux 11, 12, 27 de la poignée de manœuvre 2, le praticien repousse F extrémité distale de la gaine interne 8 vers les cuillers pour qu'elle vienne rapprocher les cuillers 3, 4 l'une de l'autre pour effectuer la coupe grâce à leurs bords coupants, l'extrémité distale de la gaine 8 étant alors en butée contre les cuillers, comme illustré à nouveau figure 6.The biopsy forceps are then advanced until the cutting spoons 3, 4, in the open position of the forceps, come into contact with the area from which tissue must be cut and removed. The clamp is opened by moving the pull tab 22 away from the handle 20. The distal end of the internal sheath 8 is then in the retracted position on the cable 5 as illustrated in FIG. 2. By bringing together its three fingers slipped into the rings 11 , 12, 27 of the operating handle 2, the practitioner pushes F distal end of the inner sheath 8 towards the spoons so that it comes to bring the spoons 3, 4 together to carry out the cutting thanks to their sharp edges, the distal end of the sheath 8 then being in abutment against the spoons, as illustrated again in FIG. 6.
Selon une forme de réalisation légèrement plus complexe, on double les moyens de blocage 40 d'un dispositif de blocage 60, en référence à la figure 3, similaire et adjacent aux moyens 40, sur le manchon 35', mais bloquant la gaine 10, cette gaine étant rendue coulissante dans le manchon. Dans cette variante, la gaine 10 est solidaire du manchon mais de façon détachable. Le manchon 35' est alors vraiment ouvert à ses deux extrémités axiales pour le coulissement du tabe 39 et de la gaine externe 10. En débloquant cette gaine 10, on peut ainsi régler la longueur de course du tabe 39 dans le manchon 35 en fonction de la longueur de course nécessaire de l'instrument 1 depuis sa position de protection dans la gaine 10 jusqu'à sa position de prélèvement.According to a slightly more complex embodiment, the locking means 40 are doubled with a locking device 60, with reference to FIG. 3, similar and adjacent to the means 40, on the sleeve 35 ′, but blocking the sheath 10, this sheath being made to slide in the sleeve. In this variant, the sheath 10 is integral with the sleeve but detachably. The sleeve 35 ′ is then really open at its two axial ends for the sliding of the tab 39 and of the external sheath 10. By unlocking this sheath 10, it is thus possible to adjust the stroke length of the tab 39 in the sleeve 35 as a function of the required stroke length of the instrument 1 from its protective position in the sheath 10 to its removal position.
Le fonctionnement général décrit ci-dessus montre bien que, aux fins de protection de la partie distale de la pince, l'ensemble peut occuper deux états, un premier état déployé et un deuxième état reployé. Dans l'état déployé, la gaine 10 recouvre les cuillers de coupe 3, 4, le bouchon de paraffine médicale obturant son extrémité pour finir de protéger les cuillers de coupe. Dans l'état reployé, la fonction de coupe peut être assurée. C'est le passage de l'état déployé à l'état reployé qui provoque l'expulsion du bouchon de protection par les cuillers de coupe. On a ainsi protégé l'instrument de coupe de toute contamination lors de son passage dans un canal opérateur d'endoscope. Lors de la biopsie, la patient n'est exposé à aucun risque infectieux. The general operation described above clearly shows that, for the purpose of protecting the distal part of the clamp, the assembly can occupy two states, a first deployed state and a second folded state. In the deployed state, the sheath 10 covers the cutting spoons 3, 4, the medical paraffin plug closing off its end to finish protecting the cutting spoons. In the folded back state, the cutting function can be ensured. It is the transition from the deployed state to the folded state which causes the protective cap to be expelled by the cutting spoons. The cutting instrument was thus protected from any contamination during its passage through an endoscope operating channel. During the biopsy, the patient is not exposed to any risk of infection.

Claims

REVENDICATIONS
1. Pince à biopsie endoscopique comportant des moyens de coupe (3, 4) montés sur une extrémité distale d'un câble (5) qui s'étend dans une gaine interne (8) montée mobile dans une gaine externe (10) et des moyens de manœuvre (2) desquels les extrémités proximales de la gaine externe (10) et du câble (5) sont solidaires, l' extrémité proximale de la gaine interne (8) étant solidaire d'une tirette (22) montée coulissante sur les moyens de manœuvre (2) pour actionner les moyens de coupe (3, 4), caractérisée par le fait que les moyens de manœuvre (2) comportent deux parties, une poignée de manœuvre (20), de laquelle le câble (5) est solidaire et sur laquelle est montée la tirette (22), et un manchon de manœuvre (35), duquel la gaine externe (10) est solidaire, la poignée (20) et la tirette (22) étant agencées pour être déplacées vers le manchon (35) pour sortir les moyens de. coupe hors de l'extrémité distale de la gaine externe (10).1. Endoscopic biopsy forceps comprising cutting means (3, 4) mounted on a distal end of a cable (5) which extends in an internal sheath (8) movably mounted in an external sheath (10) and operating means (2) of which the proximal ends of the external sheath (10) and of the cable (5) are integral, the proximal end of the internal sheath (8) being integral with a pull (22) slidably mounted on the operating means (2) for actuating the cutting means (3, 4), characterized in that the operating means (2) comprise two parts, an operating handle (20), of which the cable (5) is integral and on which is mounted the pull tab (22), and an operating sleeve (35), of which the external sheath (10) is integral, the handle (20) and the pull tab (22) being arranged to be moved towards the sleeve (35) to exit the means of. cut out of the distal end of the outer sheath (10).
2. Pince selon la revendication 1, dans laquelle les moyens de coupe (3, 4) sont agencés pour éjecter, en sortant de l'extrémité distale de la gaine externe (10), un bouchon de paraffine médicale (50).2. Pliers according to claim 1, in which the cutting means (3, 4) are arranged to eject, leaving the distal end of the external sheath (10), a plug of medical paraffin (50).
3. Pince selon l'une des revendications 1 et 2, dans laquelle la poignée (20) et le manchon de manœuvre (35) sont agencés pour venir en butée l'un contre l'autre et reconstitaer ainsi un organe de manœuvre unitaire et solidariser ainsi la gaine externe (10) et le câble (5) en déplacement.3. Clamp according to one of claims 1 and 2, in which the handle (20) and the operating sleeve (35) are arranged to come into abutment against one another and thus reconstitute a unitary operating member and thus secure the outer sheath (10) and the cable (5) while moving.
4. Pince selon la revendication 3, dans laquelle le manchon (35) est monté coulissant sur un tube (39) solidaire de la poignée (20). 4. Pliers according to claim 3, in which the sleeve (35) is slidably mounted on a tube (39) integral with the handle (20).
5. Pince selon l'une des revendications 3 et 4, dans laquelle le manchon de manœuvre (35) comporte des moyens de blocage (40) en position sur la gaine interne (8) que l'opérateur maintient donc à l'état de blocage pendant la phase d'introduction et de déplacement de la pince dans un canal opérateur, avant de les débloquer pour faire coulisser la gaine interne (8) et le câble (5) dans la gaine externe (10), jusqu'en position de coupe.5. Clamp according to one of claims 3 and 4, in which the maneuvering sleeve (35) comprises locking means (40) in position on the internal sheath (8) which the operator therefore maintains in the state of blocking during the insertion and displacement phase of the clamp in an operating channel, before unlocking them to slide the internal sheath (8) and the cable (5) in the external sheath (10), until the position of chopped off.
6. Pince selon l'une des revendications 3 et 4, dans laquelle le manchon de manœuvre (35) comporte des moyens de freinage en position sur la gaine interne6. Gripper according to one of claims 3 and 4, in which the maneuvering sleeve (35) comprises braking means in position on the internal sheath
(8) que l'opérateur maintient donc à l'état de blocage pendant la phase d'introduction et de déplacement de la pince dans un canal opérateur, avant de les débloquer pour faire coulisser la gaine interne (8) et le câble (5) dans la gaine externe (10), jusqu'en position de coupe.(8) which the operator therefore maintains in the blocking state during the insertion and displacement phase of the clamp in an operating channel, before unlocking them to make the internal sheath (8) and the cable (5) slide. ) in the outer sheath (10), up to the cutting position.
7. Pince selon l'une des revendications 1 à 6, dans laquelle le manchon de manœuvre (35') est monté solidaire de la gaine externe (10) de façon détachable et réglable.7. Clamp according to one of claims 1 to 6, in which the operating sleeve (35 ') is mounted integral with the outer sheath (10) in a detachable and adjustable manner.
8. Pince selon l'une des revendications 1 à 7, dans laquelle le manchon de manœuvre (35) porte un loquet (40) de blocage de la gaine interne (8), monté coulissant transversalement sur le manchon (35 ; 35') et dans lequel sont ménagées une lumière rétrécie (43) et une lumière élargie (44) de blocage ou de freinage qui communiquent entre elles.8. Clamp according to one of claims 1 to 7, in which the operating sleeve (35) carries a latch (40) for blocking the internal sheath (8), mounted to slide transversely on the sleeve (35; 35 ') and in which are provided a narrowed light (43) and an enlarged light (44) for blocking or braking which communicate with each other.
9. Pince selon la revendication 8, dans laquelle il est prévu un deuxième loquet (60) de blocage de la gaine externe (10), monté coulissant transversalement sur le manchon (35'). 9. Pliers according to claim 8, in which there is provided a second latch (60) for blocking the external sheath (10), mounted to slide transversely on the sleeve (35 ').
PCT/FR2003/001746 2002-06-11 2003-06-11 Endoscopic biopsy forceps with protected cutting instrument WO2003103503A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003255661A AU2003255661A1 (en) 2002-06-11 2003-06-11 Endoscopic biopsy forceps with protected cutting instrument

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR02/07142 2002-06-11
FR0207142A FR2840524B1 (en) 2002-06-11 2002-06-11 ENDOSCOPIC BIOPSY FORCEPS WITH PROTECTIVE CUTTING INSTRUMENT

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AU (1) AU2003255661A1 (en)
FR (1) FR2840524B1 (en)
WO (1) WO2003103503A1 (en)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5921915A (en) * 1997-04-30 1999-07-13 C.R. Bard, Inc. Directional surgical device for use with endoscope, gastroscope, colonoscope or the like
EP1066795A1 (en) * 1999-07-09 2001-01-10 Odon Life Technology Endoscopic biopsy forceps
DE10038085A1 (en) * 1999-08-04 2001-03-22 Asahi Optical Co Ltd Operation wire coupling portion for connecting treatment tool to endoscope, has connection groove formed with different minute width sections for coupling with coupling rods of various thickness

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5921915A (en) * 1997-04-30 1999-07-13 C.R. Bard, Inc. Directional surgical device for use with endoscope, gastroscope, colonoscope or the like
EP1066795A1 (en) * 1999-07-09 2001-01-10 Odon Life Technology Endoscopic biopsy forceps
FR2795942A1 (en) 1999-07-09 2001-01-12 Odon Lifetechnology ENDOSCOPIC BIOPSY FORCEPS
DE10038085A1 (en) * 1999-08-04 2001-03-22 Asahi Optical Co Ltd Operation wire coupling portion for connecting treatment tool to endoscope, has connection groove formed with different minute width sections for coupling with coupling rods of various thickness

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FR2840524A1 (en) 2003-12-12
AU2003255661A1 (en) 2003-12-22
FR2840524B1 (en) 2005-02-04

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